Bilateral ultrasound-guided transversus abdominis plane block combined with ilioinguinal-iliohypogastric nerve block for cesarean delivery anesthesia.

The ultrasound-guided transversus abdominis plane block and ilioinguinal-iliohypogastric nerve block have been shown to provide pain relief after abdominal surgery. A combination of the 2 blocks may provide acceptable surgical anesthesia for cesarean delivery. We describe 4 women who had contraindications to neuraxial anesthesia, who underwent cesarean delivery with ultrasound-guided bilateral transversus abdominis plane block combined with ilioinguinal-iliohypogastric nerve block using 40 mL 0.5% ropivacaine. Breakthrough pain during the delivery of the fetus was treated with small doses of IV ketamine and propofol. We suggest that this technique may be an alternative to local anesthesia for cesarean delivery in clinical practice.

[1]  Kevin B. Kinnee.  [Infiltration]. , 2020, Gazette medicale de France.

[2]  F. Phillips,et al.  Ultrasound-guided Transversus Abdominis Plane Block for Analgesia After Caesarean Delivery , 2010 .

[3]  T. W. Lee,et al.  Comparison of Extent of Sensory Block following Posterior and Subcostal Approaches to Ultrasound-Guided Transversus Abdominis Plane Block , 2010, Anaesthesia and intensive care.

[4]  F. Phillips,et al.  Ultrasound-guided transversus abdominis plane block for analgesia after Caesarean delivery. , 2009, British journal of anaesthesia.

[5]  J. Barry,et al.  Intravenous oxytocin bolus of 2 units is superior to 5 units during elective Caesarean section. , 2008, British journal of anaesthesia.

[6]  G. Kostopanagiotou,et al.  Excretion of Ropivacaine in Breast Milk During Patient-Controlled Epidural Analgesia After Cesarean Delivery , 2008, Regional Anesthesia & Pain Medicine.

[7]  G. I. Taylor,et al.  Refining the course of the thoracolumbar nerves: A new understanding of the innervation of the anterior abdominal wall , 2008, Clinical anatomy.

[8]  Jeffrey S. Lee,et al.  Bilateral ultrasound-guided continuous ilioinguinal-iliohypogastric block for pain relief after cesarean delivery. , 2008, Anesthesia and analgesia.

[9]  Y. Shibata,et al.  Ultrasound-guided transversus abdominis plane (TAP) block. , 2007, Anaesthesia and intensive care.

[10]  M. Christakis,et al.  Sonographically Guided Ilioinguinal Nerve Block , 2006, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[11]  J. Meiring,et al.  Anatomical considerations of the pediatric ilioinguinal/iliohypogastric nerve block , 2005, Paediatric anaesthesia.

[12]  J. Mcclure,et al.  Ropivacaine 0.75% for extradural anaesthesia in elective caesarean section: an open clinical and pharmacokinetic study in mother and neonate. , 1997, British journal of anaesthesia.

[13]  A. Bodenham,et al.  Infiltration anaesthesia in the management of Caesarean section in a patient with peripartum cardiomyopathy , 1996, Anaesthesia.

[14]  C. Fish.  Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk , 1986 .

[15]  J. Ivanusic,et al.  Determination of spread of injectate after ultrasound-guided transversus abdominis plane block: a cadaveric study. , 2009, British journal of anaesthesia.

[16]  M. Diop,et al.  Emergence and distribution of the ilioinguinal nerve in the inguinal region: applications to the ilioinguinal anaesthetic block (about 100 dissections) , 2009, Surgical and Radiologic Anatomy.

[17]  J. S. Thomas,et al.  Haemodynamic effects of oxytocin given as i.v. bolus or infusion on women undergoing Caesarean section. , 2007, British journal of anaesthesia.

[18]  M. Cooper,et al.  Local anaesthetic infiltration for caesarean section. , 1989, Anaesthesia and Intensive Care.

[19]  B. Anson,et al.  Points of parietal perforation of the ilioinguinal and iliohypogastric nerves in relation to optimal sites for local anaesthesia. , 1952, Quarterly bulletin. Northwestern University (Evanston, Ill.). Medical School.